Provider Demographics
NPI:1154138691
Name:NETTIE CAMBRIA COUNSELING LLC
Entity type:Organization
Organization Name:NETTIE CAMBRIA COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMBRIA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:717-343-2948
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:DANNEMORA
Mailing Address - State:NY
Mailing Address - Zip Code:12929-0608
Mailing Address - Country:US
Mailing Address - Phone:717-343-2948
Mailing Address - Fax:
Practice Address - Street 1:4297 RHODE ISLAND CT
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-9104
Practice Address - Country:US
Practice Address - Phone:717-343-2948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health